Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Feyissa Jafar Wagesso

Individual provider Assisted Living Facility (Behavioral Disturbances) · NPI 1699511253

Feyissa Jafar Wagesso is an Assisted Living Facility (Behavioral Disturbances) in Maplewood, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2

Practice location Address checks out

2468 Brenner Ave E
Maplewood, MN 55109-1573
Phone: (763) 910-7300
Fax: (218) 979-7692
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X
Assisted Living Facility (Behavioral Disturbances) Taxonomy 3104A0630X

Record details

NPI number1699511253
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 3, 2024
Last updated in NPPESAugust 8, 2025
Certification dateAugust 8, 2025